- Email: [email protected]
13.0 Neurogenetic Syndromes Associated With Autism Spectrum Disorder: Three Syndromes That Include Atypical Social Interaction
CLINICAL PERSPECTIVES 12.3 — 13.1
12.3 OVERVIEW OF THE DEVELOPMENTS IN CHILD AND ADOLESCENT PSYCHIATRY AND PEDIATRIC INTEGRATED CARE IN LITHUANIA Sigita Lesinskiene, MD, Lithuanian Society for Child and Adolescent Psychiatry, [email protected] Objectives: The field of child and adolescent psychiatry is actively growing and strengthening, keeping traditions and constantly changing them, according to the times. Stemming from pediatrics, the specialty of child psychiatry still strongly collaborates with pediatrics. The objective of the presentation is to analyze pathways of development of child mental health services and the process of building pediatric integrated care in Lithuania. Methods: A historic overview from the beginning of the specialties to later stages through various socioeconomic periods will be presented, highlighting strengths, weaknesses, and challenges to further development. Ways on how to achieve the best balance between public health interventions and individual integrated medical care will also be discussed. System of service delivery, funding, and training of specialists in Lithuania will be presented. Results: Pediatrics and child psychiatry were developing at the same time in parallel, and pathways of mutual cooperation and integration were built between them throughout the country for both outpatient and inpatient services. Good examples of these developments will be presented. Child and adolescent psychiatry, one of the most socially and multidisciplinaryoriented medical specialties, has been stressing intersectoral collaboration for many years. In recent years, awareness of the urgent need for intersectoral cooperation and integrated pediatric and child and adolescent psychiatric services to solve complex problems related to the mental health of children and adolescents has been recognized, and programs have begun to be implemented in society. Good practices, successful examples, and innovative programs, along with the need to build comprehensive, continuous services, will be discussed as a means to achieve a better quality of care. Conclusions: In the countries where financial resources are quite limited, it is very important to cooperate with politicians and decide priorities for funding when talking about the improvement of child and youth mental health. Cooperation with sectors of education and social affairs is constantly growing and is very important. Intersectoral collaboration is essential for building a healthy society. Intersectoral action remains a complex and challenging area of policy development and practice.
ADOL, DTT, TREAT http://dx.doi.org/10.1016/j.jaac.2017.07.072
12.4 IACAPAP ICAMH VOLUNTEER TEACHING PROGRAM Julie Chilton, MD, Yale University, [email protected] Objectives: The goal of this session is to increase awareness of a new teaching opportunity in low- and middle-income countries for child psychiatrists. Methods: Dr. Julie Chilton, MD, will discuss a new volunteer-teaching initiative from the International Association of Child and Adolescent Psychiatry and Allied Professions (IACAPAP), called the International Child and Adolescent Mental Health (iCAMH) Training Program, which is a free 24–30-hour competency-based training program for clinicians in low- and middle-income countries that have no previous formal child psychiatry training but are nevertheless the first-line providers of child and adolescent mental healthcare. It is geared toward pediatricians or general psychiatrists and their trainees, who first must complete the IACAPAP massive open online course (MOOC) before requesting an iCAMH team of two visiting child psychiatrists to come to their community to collaboratively learn and teach practical skills. The teaching is based on the foundation created by the World Health Organization Mental Health Gap Action Program (mhGAP), the IACAPAP Online Textbook of Child and Adolescent Mental Health, and the specific psychiatric needs of the community requesting the iCAMH training. The program was developed by Henrikje Klasen, an anthropologist and child psychiatrist who is the training director at The Hague in The Netherlands and a past mhGAP volunteer.
JOURNAL OF THE AMERICAN ACADEMY OF CHILD & ADOLESCENT P SYCHIATRY VOLUME 56 NUMBER 10S OCTOBER 2017
Results: Since 2015, three pilot programs have taken place in Ethiopia, with final-year pediatric residents at Addis Ababa University and one program completed in Sri Lanka with adult psychiatrists. Conclusions: Dr. Chilton will present a summary of the program, information for interested iCAMH participants, lessons learned, and ideas for the future. She will also solicit feedback from fellow presenters and audience members.
EBP, REST, RP http://dx.doi.org/10.1016/j.jaac.2017.07.073
CLINICAL PERSPECTIVES 13 NEUROGENETIC SYNDROMES ASSOCIATED WITH AUTISM SPECTRUM DISORDER: THREE SYNDROMES THAT INCLUDE ATYPICAL SOCIAL INTERACTION Michelle L. Palumbo, MD, Massachusetts General Hospital and Harvard Medical School, [email protected]; Christopher J. McDougle, MD, Massachusetts General Hospital and Harvard Medical School, cmcdougle@partners. org; Ellen J. Hoffman, MD, PhD, Yale University School of Medicine, [email protected] Objectives: The neurogenetic syndromes constitute a wide array of clinical presentations, including multiple medical problems, behavioral challenges, and associated psychiatric disorders, such as ASD. This seminar will be a follow up to a previous clinical perspectives session on three neurogenetic syndromes associated with autism spectrum disorder (ASD) focusing on Down syndrome, fragile X syndrome, and Angelman syndrome. Methods: This seminar will consist of four presentations presenting different aspects of these three syndromes. The first presentation by Michelle L. Palumbo, MD, will review the clinical phenomenology, including frequently encountered medical and psychiatric comorbidities in each of the three neurogenetic syndromes. In the second presentation, Barbara Pober, MD, will review the genetic mechanisms underlying each of the three syndromes. In the third presentation, David S. Hong, MD, will discuss neuroimaging as it relates to the three syndromes. In the fourth presentation, Christopher J. McDougle, MD, will discuss psychopharmacological treatment of psychiatric symptoms that commonly occur in the three neurogenetic syndromes associated with ASD. A question and answer session will be conducted at the end. Results: The attendees will gain further knowledge of neurogenetic syndromes associated with ASD. Conclusions: The overall goal of this seminar is to provide knowledge of three neurogenetic syndromes associated with ASD to provide assistance to the general child and adolescent psychiatrist when caring for these patients.
GS, PPC, ASD http://dx.doi.org/10.1016/j.jaac.2017.07.075
13.1 THE CLINICAL PRESENTATION OF THREE NEUROGENETIC SYNDROMES ASSOCIATED WITH AUTISM SPECTRUM DISORDER Michelle L. Palumbo, MD, Massachusetts General Hospital and Harvard Medical School, [email protected] Objectives: A significant number of neurogenetic syndromes are associated with autism spectrum disorder (ASD). It is important for clinicians to not only be able to recognize these syndromes but to be aware of frequently encountered medical and psychiatric comorbidities. This presentation will focus on the clinical presentations, including common medical and psychiatric comorbidities, of Down syndrome, fragile X syndrome, and Angelman syndrome. Methods: The presentation will begin with a brief review of dysmorphic features of the three syndromes and the dysmorphology exam. A review of the characteristically identifying physical features, commonly observed behavioral phenotypes, and frequently encountered medical and psychiatric
www.jaacap.org
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12.3 OVERVIEW OF THE DEVELOPMENTS IN CHILD AND ADOLESCENT PSYCHIATRY AND PEDIATRIC INTEGRATED CARE IN LITHUANIA Sigita Lesinskiene, MD, Lithuanian Society for Child and Adolescent Psychiatry, [email protected] Objectives: The field of child and adolescent psychiatry is actively growing and strengthening, keeping traditions and constantly changing them, according to the times. Stemming from pediatrics, the specialty of child psychiatry still strongly collaborates with pediatrics. The objective of the presentation is to analyze pathways of development of child mental health services and the process of building pediatric integrated care in Lithuania. Methods: A historic overview from the beginning of the specialties to later stages through various socioeconomic periods will be presented, highlighting strengths, weaknesses, and challenges to further development. Ways on how to achieve the best balance between public health interventions and individual integrated medical care will also be discussed. System of service delivery, funding, and training of specialists in Lithuania will be presented. Results: Pediatrics and child psychiatry were developing at the same time in parallel, and pathways of mutual cooperation and integration were built between them throughout the country for both outpatient and inpatient services. Good examples of these developments will be presented. Child and adolescent psychiatry, one of the most socially and multidisciplinaryoriented medical specialties, has been stressing intersectoral collaboration for many years. In recent years, awareness of the urgent need for intersectoral cooperation and integrated pediatric and child and adolescent psychiatric services to solve complex problems related to the mental health of children and adolescents has been recognized, and programs have begun to be implemented in society. Good practices, successful examples, and innovative programs, along with the need to build comprehensive, continuous services, will be discussed as a means to achieve a better quality of care. Conclusions: In the countries where financial resources are quite limited, it is very important to cooperate with politicians and decide priorities for funding when talking about the improvement of child and youth mental health. Cooperation with sectors of education and social affairs is constantly growing and is very important. Intersectoral collaboration is essential for building a healthy society. Intersectoral action remains a complex and challenging area of policy development and practice.
ADOL, DTT, TREAT http://dx.doi.org/10.1016/j.jaac.2017.07.072
12.4 IACAPAP ICAMH VOLUNTEER TEACHING PROGRAM Julie Chilton, MD, Yale University, [email protected] Objectives: The goal of this session is to increase awareness of a new teaching opportunity in low- and middle-income countries for child psychiatrists. Methods: Dr. Julie Chilton, MD, will discuss a new volunteer-teaching initiative from the International Association of Child and Adolescent Psychiatry and Allied Professions (IACAPAP), called the International Child and Adolescent Mental Health (iCAMH) Training Program, which is a free 24–30-hour competency-based training program for clinicians in low- and middle-income countries that have no previous formal child psychiatry training but are nevertheless the first-line providers of child and adolescent mental healthcare. It is geared toward pediatricians or general psychiatrists and their trainees, who first must complete the IACAPAP massive open online course (MOOC) before requesting an iCAMH team of two visiting child psychiatrists to come to their community to collaboratively learn and teach practical skills. The teaching is based on the foundation created by the World Health Organization Mental Health Gap Action Program (mhGAP), the IACAPAP Online Textbook of Child and Adolescent Mental Health, and the specific psychiatric needs of the community requesting the iCAMH training. The program was developed by Henrikje Klasen, an anthropologist and child psychiatrist who is the training director at The Hague in The Netherlands and a past mhGAP volunteer.
JOURNAL OF THE AMERICAN ACADEMY OF CHILD & ADOLESCENT P SYCHIATRY VOLUME 56 NUMBER 10S OCTOBER 2017
Results: Since 2015, three pilot programs have taken place in Ethiopia, with final-year pediatric residents at Addis Ababa University and one program completed in Sri Lanka with adult psychiatrists. Conclusions: Dr. Chilton will present a summary of the program, information for interested iCAMH participants, lessons learned, and ideas for the future. She will also solicit feedback from fellow presenters and audience members.
EBP, REST, RP http://dx.doi.org/10.1016/j.jaac.2017.07.073
CLINICAL PERSPECTIVES 13 NEUROGENETIC SYNDROMES ASSOCIATED WITH AUTISM SPECTRUM DISORDER: THREE SYNDROMES THAT INCLUDE ATYPICAL SOCIAL INTERACTION Michelle L. Palumbo, MD, Massachusetts General Hospital and Harvard Medical School, [email protected]; Christopher J. McDougle, MD, Massachusetts General Hospital and Harvard Medical School, cmcdougle@partners. org; Ellen J. Hoffman, MD, PhD, Yale University School of Medicine, [email protected] Objectives: The neurogenetic syndromes constitute a wide array of clinical presentations, including multiple medical problems, behavioral challenges, and associated psychiatric disorders, such as ASD. This seminar will be a follow up to a previous clinical perspectives session on three neurogenetic syndromes associated with autism spectrum disorder (ASD) focusing on Down syndrome, fragile X syndrome, and Angelman syndrome. Methods: This seminar will consist of four presentations presenting different aspects of these three syndromes. The first presentation by Michelle L. Palumbo, MD, will review the clinical phenomenology, including frequently encountered medical and psychiatric comorbidities in each of the three neurogenetic syndromes. In the second presentation, Barbara Pober, MD, will review the genetic mechanisms underlying each of the three syndromes. In the third presentation, David S. Hong, MD, will discuss neuroimaging as it relates to the three syndromes. In the fourth presentation, Christopher J. McDougle, MD, will discuss psychopharmacological treatment of psychiatric symptoms that commonly occur in the three neurogenetic syndromes associated with ASD. A question and answer session will be conducted at the end. Results: The attendees will gain further knowledge of neurogenetic syndromes associated with ASD. Conclusions: The overall goal of this seminar is to provide knowledge of three neurogenetic syndromes associated with ASD to provide assistance to the general child and adolescent psychiatrist when caring for these patients.
GS, PPC, ASD http://dx.doi.org/10.1016/j.jaac.2017.07.075
13.1 THE CLINICAL PRESENTATION OF THREE NEUROGENETIC SYNDROMES ASSOCIATED WITH AUTISM SPECTRUM DISORDER Michelle L. Palumbo, MD, Massachusetts General Hospital and Harvard Medical School, [email protected] Objectives: A significant number of neurogenetic syndromes are associated with autism spectrum disorder (ASD). It is important for clinicians to not only be able to recognize these syndromes but to be aware of frequently encountered medical and psychiatric comorbidities. This presentation will focus on the clinical presentations, including common medical and psychiatric comorbidities, of Down syndrome, fragile X syndrome, and Angelman syndrome. Methods: The presentation will begin with a brief review of dysmorphic features of the three syndromes and the dysmorphology exam. A review of the characteristically identifying physical features, commonly observed behavioral phenotypes, and frequently encountered medical and psychiatric
www.jaacap.org
S19